Epistaxis, colloquially known as nosebleeds, is a condition indicated by streams of blood trickling or dripping from the nostril(s). It is a relatively common occurrence for those under the age of ten or over the age of fifty, with most individuals experiencing at least one nosebleed during their lifetime. However, it can still be an unsettling and unanticipated experience. While most cases of nosebleeds are harmless and self-treatable, it is important to understand the causes, symptoms, and appropriate treatment methods to manage oneself in the event of one in an effective manner.

Primarily, it is crucial to decipher that there are numerous factors which may contribute to the event of a nosebleed. For instance, inhabiting regions with arid climatic conditions which have lower levels of air humidity can lead to dryness and irritation of the nasal passages, making the blood capillaries in the nasal lining more susceptible to rupture. Fortuitous traumatic injury to the nose, such as blows and strikes, can damage the intricate blood vessels in the nostrils, leading to nosebleeds. Habitual nose-picking, needlessly vigorous blowing of the nose, or insertion of foreign objects can disturb the sensitive nasal membranes, causing epistaxis. Nasal infections, such as sinusitis or common colds, can cause inflammation and nasal congestion, increasing the potential for nose bleeding. Allergic reactions, principally to airborne allergens for instance pollen and dust clusters, can create traffic congestion and repetitive sneezing, which can trigger nosebleeds. Anatomical abnormalities and structural flaws in the nasal passages, such as deviated septum or nasal polyps, can also cause concurrent nosebleeds. Certain prescription medications, anticoagulants (blood thinners) or antiplatelet drugs, can interfere with blood clotting mechanisms, making individuals more prone to nosebleeds. Posterior epistaxis occurs when there is a sensation and distinct taste of blood or other biofluids flowing down the back of the throat. The presence of blood whilst blowing the nose and/or mild to moderate discomfort or pain in the nasal vicinity may also indicate epistaxis.

Most nosebleeds can be handled at home by following the correct protocols:

  • Remain calm: Stay calm and sit in an upright posture to prevent blood from flowing down the throat.
  • Pinch Nose: Use one’s thumb and index finger to pinch the soft cartilage of the nose just below the nasal bone. Sustain pressure for ten to fifteen minutes without releasing, whilst breathing normally through the mouth.
  • Lean Forward: Tilt the head slightly forward to help prevent blood from flowing down the throat. Avoid tilting the head backwards as it may lead to ingestion of blood.
  • Apply Ice: Place a frigid compress or ice pack on the bridge of the nose to aid in the constriction of blood vessels and ease the flow of blood.
  • Moisturise Nasal Passages: Apply a slim layer of petroleum jelly or saline nasal spray to moisten and soothe the nasal membranes, preventing aridity and further irritation.

While the majority of nosebleeds can be managed with standard first-aid procedures, professional medical attention must be pursued in certain situations:

  • The bleeding does not cease post twenty minutes of continuous pressure.
  • Nosebleeds occur more than sporadically and without any apparent cause.
  • There is severe blood deficit or light-headedness.
  • Nosebleeds are accompanied by other concerning symptoms like migraines, easy bruising or distortions in vision.

There are various methods of medical interventions for epistaxis. For example, cauterisation is a procedure involving the use of heat, chemicals or electrical current to seal off erupted blood vessels in the nasal lining. Nasal packing is used in situations of extreme posterior epistaxis; and involves placing a sterile material such as gauze or an inflatable balloon into the nasal cavity to apply pressure and help control the bleeding. Nasal vasoconstrictors include topical nasal sprays or gels, typically applied directly to the affected nostril to assist in narrowing the blood vessels.

In adverse circumstances, where cases of epistaxis are recurrent and do not respond to conventional treatment methods, surgery will be required. Procedures include arterial ligation (knotting off the bleeding blood vessel), and embolization (blocking the blood supply to the bleeding vessel). These are performed to address the underlying cause and prevent future episodes of epistaxis.

For nosebleeds associated with higher blood pressure, medications to manage hypertension may be recommended, and, likewise, the corresponding medication is prescribed for epistaxis rooted in other medical disorders. This is a fundamental concept to be understood in dealing with this enigmatic issue.

Wrapping up, proper understanding and appropriate interventions can effectively manage epistaxis a.k.a. nosebleeds. While most cases can be managed at home with measures like applying pressure and avoiding further irritation, depending on severity and recurrence, nosebleeds may require medical interventions such as cauterisation, nasal packing or surgery. Seeking medical attention and addressing underlying causes is essential for efficient management. Individuals can gain control over their nosebleeds by working closely with healthcare professionals, enhancing their quality of daily living and navigating tasks and other activities with self-confidence.

Article Credits
Dr. A.M Khader, ENT Specialist, CareMithra
Rohan Panicker, Creative Writer, CareMithra